Gastro-esophageal reflux (GER) is the backward flow of stomach contents up the esophagus and sometimes even into or out of the mouth. At the lower end of the esophagus, the lower esophageal sphincter (LES) opens when food is swallowed and then normally closes again to keep stomach contents in place.
When the LES is not working properly, with GER the stomach content including hydrochloric acid, comes into contact with the esophagus, throat, nasal cavities, lungs and/or teeth, causing pain and damage. Over time, repeated exposure of these areas with acid can cause increasing damage and cause more serious complications.
At least 50% of infants are born with some degree of GER due to immaturity of the LES. Most of these infants will not have major complications and will outgrow it before they are a year old. It is estimated that about 3% will not outgrow it and will experience the more serious complications related to gastro-esophageal reflux disease (GERD).
Hence, GER(D) is especially a problem during infancy. Besides the already above mentioned problems, GER(D) in infants may result in dehydration, impaired growth and/or a failure to thrive of the infant.
Nutrilon A.R. 1 is a commercially available infant formula intended for infants having GER. It comprises 0.4 g per 100 ml of the thickener locust bean gum. It comprises 1.6 g protein per 100 ml with a weight ratio of casein to whey protein of 8 to 2.
Gallia A.R. 1 is a commercially available infant formula comprising 0.5 g per 100 ml of the thickener locust bean gum. It is intended for infants suffering from GER. It comprises 1.6 g protein with a weight ratio casein to whey protein of 6 to 4.
EP 0 745 330 discloses an infant formula containing as thickening agents useful for treating regurgitation potato starch, waxy grain starch (e.g. waxy corn starch, waxy rice starch) or a mixture thereof. Disadvantageously starch replaces lactose as digestible carbohydrate source, which is not desired since lactose is the main source of digestible carbohydrates in human milk. Moreover, starch is degradable by alpha-amylase and therefore less efficient as thickener.
EP 0 611 525 discloses a milk for infants that is prepared by pre-heating, addition of 0.3-1% (based on total weight of the sterilised, packaged milk) of carob, guar, carrageen and/or pectins, as thickeners, homogenisation, treating at ultra high temperature, and packaging.
FR 2913857 discloses the preparation of anti-regurgitation infant milk in powder form and an infant milk powder comprising 1-5 wt. % based on dry weight of carob flour.
JP2003245039 discloses a gastro-esophageal reflux suppressing formula milk suitable for dietetic therapy of infant gastro-esophageal reflux diseases, the viscosity of which is low when dissolved, and increased after suckled.
EP 1 930 407 A1 discloses Bifidobacterium bifidum which has an effect of killing Helicobacter pylori and shows high survivability even in the case of being stored in a fermented milkfood or drink under aerobic condition.